title: Successful IVUS-guided reentry from iatrogenic coronary arteriovenous fistula related to wire perforation following wiring of a totally occluded vessel.
abstract: We experienced a rare case in which a guidewire was advanced into a coronary vein through an arteriovenous fistula caused by wire perforation. The patient, who had chronic total occlusion (CTO) of the left circumflex coronary artery, was treated successfully with a procedure guided by intravascular ultrasound (IVUS). The IVUS-guided parallel-wire technique allowed recrossing of the guidewire into the distal true lumen of the CTO by identifying the anatomy of the occluded segment and the appropriate re-entry point. Angiography demonstrated that the fistula was completely sealed after stent deployment, and there was no extravasation.
authors.affiliation: Division of Cardiology, Kusatsu Heart Center, Kusatsu, Shiga 525-0014, Japan. ohya@kusatsu-heartcenter.co.jp
authors.forename: Hidefumi
authors.initials: H
authors.lastname: Ohya
authors.forename: Eisho
authors.initials: E
authors.lastname: Kyo
authors.forename: Osamu
authors.initials: O
authors.lastname: Katoh
mesh_terms: D000369:Aged, 80 and over; D001164:Arteriovenous Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000293:injuries*; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional